Hopkins Stephanie, Yang Victor, Liew David Fl
Austin Health, Melbourne.
Department of Medicine, The University of Melbourne.
Aust Prescr. 2025 Aug;48(4):139-144. doi: 10.18773/austprescr.2025.032.
Nonsteroidal anti-inflammatory drugs (NSAIDs) are useful for many conditions, frequently in preference to other therapies such as opioids. They play an important role in osteoarthritis, headache disorders, acute musculoskeletal injury, dysmenorrhoea and dental pain. In axial spondyloarthritis, they can modify disease and represent first-line therapy. Most NSAIDs have comparable efficacy for most conditions, despite their different pharmacodynamic effects. The pharmacokinetic profile of different NSAIDs might confer varying risks and advantages for acute or chronic conditions that influence their selection. NSAIDs have well-recognised adverse effects, including cardiovascular, renal and gastrointestinal risks. While these risks vary between NSAIDs, all of them confer some increased risk. Proton pump inhibitors reduce upper gastrointestinal complications but not lower gastrointestinal ones. Other important precautions relate to pregnancy and hypersensitivity reactions.
非甾体抗炎药（NSAIDs）对多种病症都有用，通常比其他疗法（如阿片类药物）更受青睐。它们在骨关节炎、头痛疾病、急性肌肉骨骼损伤、痛经和牙痛中发挥着重要作用。在轴性脊柱关节炎中，它们可以改善病情并作为一线治疗药物。尽管大多数非甾体抗炎药具有不同的药效学作用，但对大多数病症而言，它们的疗效相当。不同非甾体抗炎药的药代动力学特征可能会给急性或慢性病症带来不同的风险和优势，从而影响对它们的选择。非甾体抗炎药具有公认的不良反应，包括心血管、肾脏和胃肠道风险。虽然这些风险在不同的非甾体抗炎药之间有所不同，但它们都会增加一定的风险。质子泵抑制剂可减少上消化道并发症，但不能减少下消化道并发症。其他重要的注意事项涉及妊娠和过敏反应。
